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Kamb, M.L., Fishbein, M., Douglas, J.M., Rhodes, F., et al. (1998).
Journal of the American Medical Association, 280 (13), 1161-1167
Description of Intervention: Project RESPECT§
The Enhanced and Brief Counseling interventions were based on the Theory of Reasoned Action and Social Cognitive Theory. Sessions were interactive and designed to change factors that could facilitate condom use, such as self-efficacy, attitudes, and perceived norms. The study was conducted in Baltimore, Denver, Long Beach, Newark, and San Francisco. Health department staff, trained to conduct HIV counseling, delivered the intervention.
The Enhanced Counseling intervention consisted of 4 sessions, a total of 200 minutes, and was completed in 3-4 weeks.
Session 1: Assessed personal risk, identified barriers to risk reduction, and negotiated a small risk-reduction step achievable in the next week.
Session 2: Explored condom use attitudes, discussed prior week's behavior change successes and barriers, and devised a strategy for taking a risk-reduction step before the next session.
Session 3: Received HIV test results, discussed prior week's behavioral goal and condom use barriers and facilitators, built condom use self-efficacy, and devised a strategy for taking another risk-reduction step.
Session 4: Explored social norms and support for condom use, discussed prior week's behavioral goal successes and barriers, and devised a long-term strategy for consistent condom use.
The Brief Counseling intervention consisted of 2 sessions, a total of 40 minutes, and was completed in 7-10 days. It was based on the HIV Prevention Counseling recommended by CDC for use with HIV testing since 1993.
Session 1: Identical to Session 1 above.
Session 2: Received HIV test results, discussed changes, support for changes made, and barriers and facilitators to change, and developed a long-term plan for risk reduction.
Incentives included cash for intervention sessions, follow-up visits, and STD exams. |
Intervention Goal(s): To determine the effects of enhanced and brief interactive counseling interventions to reduce high-risk behavior and to prevent new STDs.
Intervention Setting: Inner-city STD clinics.
Population: Of the 5,758 HIV-seronegative adults who participated in the study, 57% were male and 43% were female; 59% were African American, 19% were Hispanic, 16% were white, and 6% were of other racial/ethnic groups. Median age of the participants was 25 years and 24% were < 20 years; 54% were unemployed.
Comparison Condition: Didactic messages typical of current care.
Behavioral Findings: Participants in both counseling interventions reported significantly higher condom use than participants in the comparison condition. Of the counseling participants, 30% fewer had new STDs than participants in the comparison condition. In the counseling interventions, benefits accrued equally to men and women, and STD reduction was higher among adolescents than older participants.
Contact:
Ken Hunt
Centers for Disease Control and Prevention
1600 Clifton Road, N.E. Mail Stop E-37
Atlanta, GA 30333
Phone: 404 639 2058
Fax: 404 639 1950
E-mail: khunt@cdc.gov
§Some information obtained from related reports or author.
Go to Cognitive-Behavioral Skills Training Group
This study meets CDC's HIV/AIDS Prevention Research Synthesis project criteria for relevance and methodological rigor and also has the positive and significant behavioral/health findings required for the Compendium. Date added 1/99
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